# The Debut Signal of Bone Metastasis and Stealthy Gastric Cancer Unmasked in a Young Male: A Case Report

## TL;DR

A young male presented with severe back pain and was diagnosed with gastric cancer that had metastasized to the bone, despite no prior GI symptoms.

## Contribution

This case highlights the rare occurrence of bone metastasis from gastric cancer without prior gastrointestinal symptoms in a young patient.

## Key findings

- A 27-year-old male was diagnosed with gastric adenocarcinoma and bone metastasis without prior GI symptoms.
- MRI confirmed bony metastases in the spine following endoscopy and biopsy.
- The patient declined palliative chemotherapy and radiotherapy.

## Abstract

Gastric cancer is the fifth leading cause of cancer-related deaths in the world. The occurrence of bone metastases (BM) in gastric cancer without prior gastrointestinal (GI) symptoms is a rare phenomenon that has been sporadically documented in the existing literature. We report a case of a 27-year-old male presenting with chief complaints of severe backache for one month.

After an upper gastrointestinal endoscopy and biopsy, the primary source of cancer was identified as a solitary gastric adenocarcinoma, supporting the diagnosis of bony metastases on the magnetic resonance imaging (MRI) of the spine. The patient was planned to start on palliative chemotherapy (5-fluorouracil, leucovorin, oxaliplatin, and docetaxel {FLOT} regimen) with palliative radiotherapy of 20 Gy in five fractions to bony metastasis. The patient denied treatment and was discharged against medical advice.